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      Counseling strategies for nutritional anemia by family physicians in Saudi Arabia, 2016: Implication for training

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          Context: Prevalence of nutritional anemia among Saudi female and children is evident and has been reflected in different studies, most of researchers conclude that there is a gap in dietary counseling in addition to the poor awareness of community about appropriate dietary habits; this study is trying to assess counseling behavior and training competency of family physician at primary health centers with respect to nutritional anemia.

          Objective: Study objective is to assess general beliefs, practice, and level of training in counseling by family physician.

          Methodology: This is a cross-sectional study design; data collected using self-administered questionnaire provided to the doctor at clinic site.

          Results: The most commonly learned counseling technique in order as follows motivational interviewing (68%), cognitive behavioral therapy (58%), and 15-Minute Hour approach (53%).

          Conclusion: This study confirms the presence of positive counseling beliefs and practices by family physicians; however, the result is also reflects the current reluctant state of family physicians in devoting ample time for nutritional anemia counseling.

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          Most cited references 9

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          Primary Care: Is There Enough Time for Prevention?

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            Khat Chewing and Restrictive Dietary Behaviors Are Associated with Anemia among Pregnant Women in High Prevalence Rural Communities in Eastern Ethiopia

            Background Anemia affects a high proportion of pregnant women in the developing countries. Factors associated with it vary in context. This study aimed to determine the prevalence and predictors of anemia among pregnant women in the rural eastern Ethiopia. Methods A community-based cross-sectional study was done on 1678 pregnant women who were selected by a cluster random sampling technique. A pregnant woman was identified as anemic if her hemoglobin concentration was <11 g/dl. Data were collected in a community-based setting. Multilevel mixed effect logistic regression was used to determine the adjusted odds ratios (AOR) with 95% confidence intervals (CI) for the predictors of anemia. Results Anemia was observed among 737(43.9%) of the 1678 pregnant women studied (95% CI 41.5%–46.3%). After controlling for the confounders, the risk of anemia was 29% higher in the women who chewed khat daily than those who sometimes or never did so (AOR, 1.29; 95% CI, 1.02–1.62). The study subjects with restrictive dietary behavior (reduced either meal size or frequency) had a 39% higher risk of anemia compared to those without restrictive dietary behavior (AOR, 1.39; 95% CI, 1.02–1.88). The risk of anemia was increased by 68% (AOR, 1.68; 95% CI, 1.15–2.47), and 60% (AOR, 1.60; 95% CI, 1.08–2.37) in parity levels of 2 births and 3 births, respectively. Compared to the first trimester, the risk of anemia was higher by two-fold (AOR, 2.09; 95% CI, 1.46–3.00) in the second trimester and by four-fold (AOR, 4.23; 95% CI, 2.97–6.02) in the third trimester. Conclusion In this study, two out of five women were anemic. Chewing khat and restrictive dietary habits that are associated with anemia in the setting should be addressed through public education programs. Interventions should also focus on the women at higher parity levels and those who are in advanced stages of pregnancy.
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              Prevalence of Anemia and Associated Factors in Child Bearing Age Women in Riyadh, Saudi Arabia

              Objective. To determine the prevalence and risk factors for anemia in child bearing age women in Riyadh, Saudi Arabia. Design. Cross-sectional survey was conducted using two-stage cluster sampling. 25 clusters (primary health care centers (PHCC)) were identified from all over Riyadh, and 45–50 households were randomly selected from each cluster. Eligible women were invited to PHCC for questionnaire filling, anthropometric measurements, and complete blood count. Blood hemoglobin was measured with Coulter Cellular Analysis System using light scatter method. Setting. PHCC. Subjects. 969 (68%) women out of 1429 women were included in the analysis. Results. Mean hemoglobin was 12.35 (±1.80) g/dL, 95% CI 12.24–12.46 with interquartile range of 1.9. Anemia (Hb <12 g/dL) was present in 40% (390) women. Mean (±SD) for MCH, MCV, MCHC, and RDW was 79.21 (±12.17) fL, 26.37 (±6.21) pg, 32.36 (±4.91) g/dL, and 14.84 (±4.65)%, respectively. Multivariate logistic regression revealed that having family history of iron deficiency anemia (OR 2.91, 95% CI 1.78–4.76) and infrequent intake of meat (OR 1.54, 95%CI 1.15–2.05) were associated with increased risk of anemia, whereas increasing body mass index (OR 0.95, 95% CI 0.92–0.97) was associated with reduced risk of anemia. Conclusion. Women should be educated about proper diet and reproductive issues in order to reduce the prevalence of anemia in Saudi Arabia.

                Author and article information

                Family Medicine and Community Health
                Compuscript (Ireland )
                December 2017
                December 2017
                : 5
                : 4
                : 259-265
                1Assistant Professor of Community Medicine, Family and Community Medicine Department, Faculty of Medicine Tabuk University, Tabuk, Kingdom of Saudi Arabia
                2Health Consultant at Vision Health Consultancy, Khartoum, Sudan
                3Faculty of medicine, Qassim University, Qassim, Kingdom of Saudi Arabia
                Author notes
                CORRESPONDING AUTHOR: Njood Suliman Muhammed ­AlBarrak, Internship student, Faculty of medicine, Qassim University, Qassim, Kingdom of Saudi Arabia, E-mail: njoodsb@ 123456hotmail.com
                Copyright © 2017 Family Medicine and Community Health

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

                Self URI (journal page): http://fmch-journal.org/
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